National Yang-Ming University, Taipei, Taiwan.
Int J Tuberc Lung Dis. 2011 Feb;15(2):192-200.
effective tuberculosis (TB) screening should be performed before anti-tumour necrosis factor alpha (TNF-α) treatment in rheumatoid arthritis (RA). The usefulness of the tuberculin skin test (TST) and QuantiFERON®-TB Gold (QFT-G) for detecting latent tuberculosis infection (LTBI) is limited.
we tested the diagnostic performance of interferon-gamma (IFN-γ) inducible protein 10 (IP-10) and IFN-γ for detecting LTBI in RA patients receiving anti-TNF-α treatment.
IP-10 levels were determined by enzyme-linked immunosorbent assay in 56 RA patients and 18 active TB patients. TST was performed using the Mantoux method and QFT-G was performed by measuring IFN-γ levels in whole blood treated with TB-specific antigens.
twenty-four (42.9%) TST-positive patients were defined as having LTBI. Significantly higher levels of baseline, early secretory antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) stimulated IP-10 were observed in active TB patients (median 209.9 pg/ml, 899.0 pg/ml and 880.2 pg/ml, respectively) and RA patients with LTBI (165.3 pg/ml, 904.4 pg/ml and 747.5 pg/ml, respectively), compared to those without LTBI (89.3 pg/ml, 579.4 pg/ml and 515.0 pg/ml, respectively). Baseline IP-10 has high sensitivity (83.3% and 100%) and medium specificity (67.9% and 59.6%), while ESAT-6-stimulated IP-10 has high sensitivity (87.5% and 100%) and specificity (85.7% and 71.2%) for detecting LTBI and TB. The performance of IP-10 is superior to IFN-γ for detecting LTBI (TST+) and active TB.
IP-10 may be used for detecting LTBI and as a potential biomarker to identify active TB in RA patients receiving anti-TNF-α treatment.
在类风湿关节炎（RA）患者接受抗肿瘤坏死因子-α（TNF-α）治疗之前，应进行有效的结核病（TB）筛查。结核菌素皮肤试验（TST）和 QuantiFERON®-TB Gold（QFT-G）检测潜伏性结核感染（LTBI）的有用性有限。
我们检测了干扰素-γ（IFN-γ）诱导蛋白 10（IP-10）和 IFN-γ在接受抗 TNF-α治疗的 RA 患者中检测 LTBI 的诊断性能。
通过酶联免疫吸附试验（ELISA）测定 56 例 RA 患者和 18 例活动性 TB 患者的 IP-10 水平。采用曼图法进行 TST，采用 TB 特异性抗原处理全血测量 IFN-γ水平进行 QFT-G。
24 例（42.9%）TST 阳性患者被定义为 LTBI。与无 LTBI 患者（89.3pg/ml、579.4pg/ml 和 515.0pg/ml）相比，活动性 TB 患者（中位值 209.9pg/ml、899.0pg/ml 和 880.2pg/ml）和 RA 患者 LTBI（165.3pg/ml、904.4pg/ml 和 747.5pg/ml）的基线、早期分泌抗原靶 6（ESAT-6）和培养滤液蛋白 10（CFP-10）刺激的 IP-10 水平显著升高。IP-10 的基线具有高灵敏度（83.3%和 100%）和中等特异性（67.9%和 59.6%），而 ESAT-6 刺激的 IP-10 对 LTBI 和 TB 的检测具有高灵敏度（87.5%和 100%）和特异性（85.7%和 71.2%）。IP-10 的性能优于 IFN-γ 用于检测 LTBI 和活动性 TB。
IP-10 可用于检测 LTBI，并作为潜在的生物标志物，用于识别接受抗 TNF-α治疗的 RA 患者中的活动性 TB。
